Efficacy of early rehabilitation after surgical repair of acute aneurysmal subarachnoid hemorrhage: outcomes after verticalization on day 2-5 versus day 12 post-bleeding

Milovanović, Aleksandra; Grujičić, Danica; Bogosavljević, Vojislav; Joković, Miloš; Mujović, Nataša; Markovic, Ivana Petronic

doi:10.5137/1019-5149.jtn.17711-16.1

Cited by 10 publications

(10 citation statements)

References 17 publications

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“…Based on these mechanisms and MFS, modified Fisher scale; HR, hazard ratio; CI, confidence interval; aSAH, aneurysmal subarachnoid hemorrhage evidence, our results suggest that initiating mobilization within 7 days after onset was not associated with SCV. In contrast, early mobilization initiated 2-5 days after onset was found to be the cause of cerebral vasospasm and delayed cerebral ischemia 20) . This previous study compared the early mobilization group (mobilization initiated 2-5 days after onset) with the non-early mobilization group (mobilization initiated after 12 days after onset), whereas this study compared the early mobilization group (mobilization initiated within 7 days after onset) with the non-early group (mobilization initiated after 7 days after onset).…”

Section: Discussionmentioning

confidence: 91%

“…A previous study suggested that early mobilization did not increase the incidence of SCV 19) . In contrast, another study found that early mobilization initiated 2-5 days after onset was caused by delayed cerebral ischemia 20) . Mobilization may increase intracranial pressure and decrease cerebral perfusion pressure, which may exacerbate cerebral vasospasm and delayed cerebral ischemia 21,22) .…”

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confidence: 94%

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Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

et al. 2022

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The study aim was to investigate the association between initiating mobilization within 7 days after onset and symptomatic cerebral vasospasm (SCV) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: This was a retrospective multicenter case-control study in Japan. Patients with a diagnosis of aSAH who underwent physical therapy with/without occupational therapy were included and categorized into 2 groups according to the presence or absence of SCV. Initiating mobilization was defined as sitting on the bed edge (at least once, with/without assist, regardless of duration) within 7 days after aSAH onset. Cox proportional hazards regression analysis was performed to evaluate the association between initiating mobilization within 7 days after onset and SCV. Results: The analysis included 510 patients. Among all included patients, 57 (11.2%) patients had SCV. In the univariate Cox proportional hazards regression analysis, initiating of mobilization was not associated with SCV (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.45-1.32). In the multivariate analysis, only the modified Fisher scale was significantly associated with SCV (HR = 26.23; 95% CI = 1.21-571.0). Conclusion: Initiating mobilization within 7 days after aSAH onset was not associated with SCV in patients with aSAH.

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Section: Discussionmentioning

confidence: 91%

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confidence: 94%

Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

et al. 2022

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“…The greater the damage, the longer the operation, the more interleukin-6 is released, the more stress develops in response [5]. A larger incision causes more pain and prevents early verticalization, which is a very important factor in the patient's recovery, return to normal functioning and reduction of postoperative complications [12]. Also, the restoration of oral nutrition minimizes the effect of stress diabetes, which is a leading factor in the healing of surgical wounds, the development of infectious postoperative complications [1,19].…”

Section: Discussionmentioning

confidence: 99%

“…The technique of simultaneous laparoscopic interventions has many opportunities for development, because comorbidity in surgical patients is not uncommon. The most common combinations of surgical pathologies within the abdominal cavity are cholecystolithiasis and diaphragmatic esophageal hernia, cholecystolithiasis and inguinal hernia, cholecystolithiasis and liver tumors, cholecystolithiasis and kidney tumors [12]. Therefore, the implementation of simultaneous surgical treatment for these groups of patients is promising.…”

Section: Discussionmentioning

confidence: 99%

Comparison of quality of life in postoperative patients with cholecystolithiasis and choledocholithiasis. The difference between open and laparoscopic treatment

Halei¹,

Dziubanovskyi²,

Marchuk³

2020

Biomed. and Biosoc. Anthrop.

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Gallstone disease is quite common in the adult population and can quickly cause life-threatening conditions that require extensive surgical treatment. In recent years, the assessment of quality of life is becoming increasingly important in world medicine as an indicator of the general condition of the patient and the effectiveness of treatment and rehabilitation measures. The aim of this work – to collect and calculate indicators of quality of life in postoperative patients with gallstones of gall bladder and common bile duct; to compare data from patients with open and laparoscopic treatment; to determine the advantages of the treatment methods. For rating quality of life 36-Item Short-Form Health Status (SF-36) was used. The statistic was collected using retrospective analysis of worked out data in laparoscopic surgery unit in Volynian regional state hospital during 2016–2019 (191 patients). Patients of group I (113 patients) underwent laparoscopic treatment, patients of group II used open surgical treatment (78 people). Statistical processing was performed using the program “Statistica 6.0” (Statsoft Inc., USA). In group I pain level in first two hours was significantly lower than in group II (6.2 vs 8.4 in 10 point scale), in addition, pain relief became faster reaching low pain level of abdomen in 2.48 days. In group II pain level was higher (8.4 points) and pain relief was reached in 5.11 days. Oral nutrition and verticalisation were renewed in 14.7±3.1 hours in group I, and in 22.9±5,5 hours in group II and 6.1±1,9 hours in group I vs 19.7±3,3 hours in group II. Also, according the results SF-36, quality of life indicators indicate faster recovery in the group of laparoscopic treatment compared to the group with the classic version of the operation. The physical functioning and physical performance of the role differed significantly in favor of laparoscopic treatment throughout the follow-up period. Pain indicators in the first group were satisfactory after 1 month of rehabilitation, while in the second group such indicators were achieved only after 6 months – 91/94/94 vs. 74/89/94. Although psychological well-being differed between 1 and 3 months, in favor of minimally invasive treatment, after 6 months the data were comparable in both groups.

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“…Concerns regarding changes in intracranial pressure and cerebral perfusion pressure due to early mobilization and their impact on the development of cerebral vasospasm and ischemia have been raised (6). In a randomized controlled study, cerebral ischemia and motor paralysis were increased when early mobilization was initiated within 2-5 days of onset (47). However, other studies have reported a decrease in SCV or no association with early mobilization (30,45).…”

Section: Several Factors May Explain the Association Between Walking ...mentioning

confidence: 94%

Association Between Early Mobilization and Functional Outcomes in Patients with Aneurysmal Subarachnoid Hemorrhage: A Multicenter Retrospective Propensity Score-Matched Study

Takara,

Suzuki,

Satoh

et al. 2024

Neurocrit Care

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BackgroundEarly mobilization is important for promoting functional recovery and preventing complications in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, the e cacy of early mobilization in patients with aSAH remains unclear. This study aimed to investigate the association between early mobilization and functional outcomes in patients with aSAH. MethodsThis multicenter retrospective study was conducted in Japan, including patients with aSAH who received physical therapy, with or without occupational therapy, from April 2014 to March 2019. The primary outcome was the modi ed Rankin Scale (mRS) score, with a favorable functional outcome de ned as an mRS score of 0-2 and an unfavorable outcome with an mRS score of 3-5. Patients initiating walking training within 14 days of aSAH onset were classi ed into the early mobilization group, whereas those initiating training after 14 days were classi ed into the delayed mobilization group. Propensity score matching analysis was performed to assess the association between early mobilization and favorable outcomes. ResultsA total of 718 patients were screened and 450 eligible patients were identi ed. Before matching, 229 patients (50.9%) were in the early mobilization group and 221 (49.1%) were in the delayed mobilization group. After matching, each group consisted of 122 patients, and the early mobilization group exhibited a higher proportion of favorable outcomes than did the delayed mobilization group (81.1% vs. 52.5%; risk difference, 28.7%; 95% CI, 17.4-39.9; p < 0.001). ConclusionsThis multicenter retrospective study suggests that initiating walking training within 14 days of aSAH onset is associated with favorable outcomes.

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Efficacy of early rehabilitation after surgical repair of acute aneurysmal subarachnoid hemorrhage: outcomes after verticalization on day 2-5 versus day 12 post-bleeding

Cited by 10 publications

References 17 publications

Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

Comparison of quality of life in postoperative patients with cholecystolithiasis and choledocholithiasis. The difference between open and laparoscopic treatment

Association Between Early Mobilization and Functional Outcomes in Patients with Aneurysmal Subarachnoid Hemorrhage: A Multicenter Retrospective Propensity Score-Matched Study

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